In fact, payment for physicians who treat Medicare patients has been controversial since 2003, when Congress passed the first of many last-ditch efforts to avoid a doctor pay cut. These last-ditch efforts are generally known as “doc-fix” bills.

Congress passed the most recent doc-fix this past Monday. The bill, called the Protecting Access to Medicare Act of 2014, skirted a looming 24 percent cut in Medicare physician payment rates.

The cut would have happened because physician payment rates are tied to a calculation that is no longer relevant. In 1997, the government developed the Medicare Sustainable Growth Rate, or SGR, which laid out how much Medicare should cost.

But the formula failed — it underestimated how quickly health care costs would grow. If the government actually did hold reimbursement rates to the SGR, Medicare physicians would, all of a sudden, receive a huge pay cut. Now, holding to the formula is politically impossible. But instead of permanently fixing Medicare payment rates and doing away with the SGR, Congress has passed temporary patches 17 times.

No politicians seem particularly happy about that. “Each year we go through a fire drill,” said Sen. Mark Warner (D-Va.) during a Senate session on March 31. “Doctors at hospitals who should be out spending time finding cheaper, better ways to deliver health care storm the halls of the Capitol to make sure that we don’t provide what would now be an unsustainable cut in their reimbursement rates.”

Many members of Congress said they hoped this year would be different — that they would be able to vote on a permanent solution.

But instead, the doc-fix passed. In fact, on March 27, it passed the House in a voice vote, which isn’t recorded. House members from both parties were irked. “A surprising twist today — who says there’s nothing surprising in Washington?” said Texas Republican Louie Gohmert during the House session. “I’m very surprised today that with us in the majority, our own leadership in charge, something as important as the doctor fix would be brought to the floor as a voice vote.”

This year’s bill also delayed implementation of a major hospital claims coding overhaul, called ICD-10, for one year. The delay left ill-prepared hospitals relieved and well-prepared hospitals frustrated that they put in the time and money to meet the deadline.

While doctors would certainly rather the doc-fix pass than not, many are unsatisfied with the rate of growth in Medicare payments. “From 2001 to 2014, the average annual Medicare physician payment update has been about 0.3 percent — barely above a freeze,” according to the American Medical Association. The AMA also claims that combined, the doc-fix bills, before this most recent one, cost more than $150 billion. “Instead of investing these funds in real physician payment reform, however, these temporary patches have left the same failed formula in place.”

There are many players with varying interests involved in discussions of Medicare spending. But it seems that everyone can agree that the doc-fix is broken. Much more difficult — passing a legitimate fix.